Evidence-based public health is defined as the development, implementation, and
evaluation of effective programs and policies in public health through applying principles
of scientific reasoning, including systematic uses of data and information systems, and
appropriate use of behavioral science theory and program planning models.1
For The State of Aging and Health in America reports,
we selected effective interventions
and programs that had been described in published peer-review literature at the time of
the report's publication. Effectiveness was based on whether researchers used sound
research designs, controlled for potential sources of biases, and the outcome measures
were of statistical and public health significance. Additionally, these programs were
either identified as part of the recommendations from
reviews (e.g., physical activity) or consistent with their approaches to
reviewing the evidence.
Reference:
-
Brownson RC, Baker EA, Leet TL, Gillespie KN. (Eds). Evidence-Based Public Health.
New York: Oxford University Press; 2003.
Physical Activity
Falls Prevention
Enhance Fitness
This evidence-based physical activity program provides seniors with low-cost fitness
classes taught by certified fitness instructors. The one-hour classes meet three times per
week in ongoing, 5-week sessions. The classes include strength training with wrist and
ankle weights, as well as aerobics, stretching, and balancing exercises. The program is
designed to be safe and effective for seniors with a wide range of physical abilities. This
program began as a partnership between Senior Services of Seattle/King County, Group
Health Cooperative of Puget Sound, and the University of Washington Health Promotion
Research Center. Studies have shown a marked improvement in participants' physical and
social functioning, as well as a decline in areas such as pain, fatigue, and depression.1 To
learn more, visit the
Project Enhance website
.
Reference:
-
Wallace JI, et al. Implementation and effectiveness of a community-based health
promotion program for older adults. Journal of Gerontology: Medical Sciences 1998;53a(4):M301–M306.
Arthritis Foundation Exercise Program
The Arthritis Foundation Exercise Program, formerly known as PACE (People with
Arthritis Can Exercise) is an evidence-based exercise program developed specifically for
people with arthritis. It uses gentle activities to help increase joint flexibility and range of
motion and maintain muscle strength. Two program levels, basic and advanced, are
available to address the varying levels of fitness and limitation among those with arthritis.
Participants have experienced such benefits as increased functional ability, increased self-
care behaviors, decreased pain, and decreased depression.1
Trained leaders are required to implement this course. For help in identifying trained
leaders in your area or for information on how to become a trained leader, contact the
Arthritis Program Director at the state health department or the state/local Arthritis
Foundation Chapter. (For a listing of directors by state, visit the
National Association of Chronic Disease Directors .
For a listing of chapters, visit the
Arthritis Foundation
.)
Reference:
-
Brady TJ, Kruger J, Helmick CG, Callahan LF, Boutaugh ML. Intervention
programs for arthritis and other rheumatic diseases. Health Education and
Behavior 2003;30(1):44–63.
Exercise: A Guide from the National Institute on Aging
The National Institute on Aging has developed a manual and companion video that
guides older adults through safe and effective endurance, strength training, balance, and
flexibility exercises. The program can be completed on an individual basis or in a group
setting. The 80-page manual is available online for free, or may be ordered along with the
video for a cost of $7.00. The video features Margaret Richard, star of PBS' exercise
show Body Electric. A Spanish language version is also available. For more information,
visit the NIH
website.
Fear of Falling: A Matter of Balance
Fear of falling is a common occurrence among older adults, including those who have not
experienced a fall. Older people often restrict their activities because they think it will
reduce their risk of falling, but this can actually lead to physical deconditioning and
increased fall risk. The Boston University Roybal Center Consortium developed this
program, which uses cognitive restructuring techniques and skills training to change
perceptions and behaviors in older adults whose activity levels have been limited by their
fears about falling. The program has been implemented successfully by senior centers,
senior housing sites, hospitals, and home health agencies.
A low-cost Facilitator's Manual and videotape provide a step-by-step implementation
guide for practitioners and providers in clinical and community settings. For more
information about the program, visit
The National Resource Center for Safe Aging
or the
Boston University
.1
Recently, the National Council on the Aging and the Administration on Aging have been
working with states to develop and test a “lay leader” model for A Matter of Balance.
Initial findings are very promising and published results should be available in the future.
For more information, visit the
Maine Department of Health
.
Reference:
-
Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A
randomized, controlled trial of a group intervention to reduce fear of falling and
associated activity restriction in older adults. Journals of Gerontology Series B —
Psychological Sciences and Social Sciences 1998;53(6):P384–92.
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